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Z Year3 Drugs > Cardiovascular drugs (Beta blocker, Antiplatelet, Anticoag, Ace-i) > Flashcards

Cardiovascular drugs (Beta blocker, Antiplatelet, Anticoag, Ace-i) Flashcards

1
Q

What are examples of beta blockers?

A
  1. Atenolol
  2. Propranolol
  3. Bisoprolol
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2
Q

What are beta blockers used to treat?

A
  1. Hypertension
  2. Angina
  3. Arrhythmias
  4. Heart failure
  5. Post MI
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3
Q

How to beta blockers work?

A

block beta adenoreceptors

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4
Q

What system does beta blockers act on?

A

antagonist of the sympathetic nervous system

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5
Q

What does blocking beta1 receptors do?

A
  • negatively inotropic and chronotropic
    1. Decreased contractility
    2. Decrease heart rate
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6
Q

What does blocking beta2 receptor do?

A

induces periperhal vasoconstriction and bronchoconstricton

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7
Q

What are key contraindications for beta blocker?

A
  1. severe asthma or COPD

2. heart block

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8
Q

What are side effects of beta blockers?

A
  1. lethargy
  2. ED
  3. nightmares
  4. headaches
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9
Q

What are examples of ACE inhibitors?

A
  1. Captopril
  2. Cilazapril
  3. Enalapril
  4. Ramipril
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10
Q

What are ACE inhibitors used to treat?

A
  1. Hypertension
  2. Heart Failure
  3. Post MI
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11
Q

How do ACE inhibitors work?

A
  1. Inhibit ACE enzyme
  2. Vasodilation
  3. Decrease BP
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12
Q

When is there concern using ACE inhibitors?

A
  1. malignant hypertension

2. CCF

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13
Q

How do you use ACE-i with CCF / malignant hypertension?

A
  1. Reduce diuretic dose initially

2. long acting ACE-i

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14
Q

What do you need to monitor with ACE-i?

A

creatinine (if rise >20% issue) and if renal function decrease check renal artery stenosis

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15
Q

When should you not use ACE inihibtors?

A
  1. AKI
  2. Hyperkalameia
  3. Avoid starting with dehydrated patient
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16
Q

What are the side effects of ACE-i?

A
  1. Dry cough

2. Urticaria

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17
Q

What are the different types of anticoagulant?

A
  1. Low molecular weight heparin (LMWH)

2. Unfractioned heparin (UFH)

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18
Q

When are anticoagulants used therapeutically?

A
  1. DVT

2. PE

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19
Q

When are anticoagulants used prophylactically?

A
  1. Prevention of DVT/PE (post op)

2. Prevention of stroke (e.g. chronic AF or prosthetic heart valves)

20
Q

What are examples of LMWH?

A
  1. Dalteparin
  2. Enoxaparin
  3. Tinzaparin
21
Q

When is LMWH used?

A

prevention and initial treatment of venous thromboembolism

22
Q

How does LMWH work?

A

inactivates factor Xa

23
Q

What are the benefits of LMWH?

A
  1. T1/2 longer than UFH
  2. One or two daily doses
  3. Lab monitoring not required
  4. Predictable effect
24
Q

What are the negatives of LMWH?

A

accumulates in renal failure

25
Q

How is UFH given?

A

IV or SC

26
Q

How does UFH work?

A
  1. binds to antithrombonin

2. increasing ability to inhibit thrombin, factor Xa and IXa

27
Q

What are the benefits of UFH?

A
  1. Rapid onset

2. Short T1/2

28
Q

What are the side effects for both types of heparin?

A
  1. Increased risk of bleeding (GI, op, cranial)
  2. Heparin induced thrombocytopenia (HIT)
  3. Osteoporosis
  4. Beware of hyperkalaemia
29
Q

What are the contraindications for both heparins?

A
  1. Bleeding disorders
  2. Platelets <60x10^9 / L
  3. Previous HIT, peptic ulcer disease, cerebral haemorrhage, severe hypertension and neurosurgery
30
Q

How does warfarin work?

A

inhibits reductase enzyme which is needed to regenerate vit K so vit K definciency

31
Q

What are the contraindications of warfarin?

A
  1. peptic ulcer
  2. bleeding disorder
  3. severe hypertension
  4. pregnancy
32
Q

What are the disadvantages of warfarin?

A
  • Change based on INR

- Narrow therapeutic window

33
Q

What is warfarin mostly used for?

A 
-LT anticoagulation 
for:
1. mechanical valves
2. AF
3. clots
34
Q

What are examples of DOACs?

A
  1. Rivaroxaban
  2. Apixaban
  3. Dabigatran (direct thrombin inhibitor)
35
Q

How does rivaroxaban and apixaban work?

A

factor Xa inhibitor

36
Q

Why DOACs better than warfarin?

A

don’t nee regular monitoring (INR)

37
Q

What are contraindication of DOAC?

A
  1. severe renal/liver impairment
  2. active bleeding
  3. lesion at risk of bleeding
  4. decrease clotting factors
38
Q

What are interactions of DOACs?

A
  1. heparin

2. clopidogrel

39
Q

What is type of anticoagulant is used for acute coronary syndrome?

A
  1. Fondaparinux: factor Xa inihbitor
  2. Bivalirudin: thrombin inihitor
  3. treatment dose LMWH
40
Q

What are different types of antiplatelet drugs?

A
  1. Aspirin
  2. ADP receptor antagonist
  3. Glycoprotein IIb/IIa antagonist
41
Q

What are the examples of ADP receptor antagonist?

A
  1. Clopidogrel
  2. Prasugrel
  3. Ticagrelor
42
Q

What is low dose aspirin (75mg/24h) used for secondary prevention of?

A
  1. post MI
  2. post TIA/stroke
  3. have angina
  4. have PVD
43
Q

How does aspirin work?

A
  1. Irreversibly acetylases COX
  2. Preventing production of thromboxane A2
  3. Inhibiting platelet aggregation
44
Q

How do ADP receptor antagonsits work?

A
  1. Block platelet aggregation

2. Less gastric irritation than aspirin

45
Q

When are ADP receptor antagonists used?

A
  1. intolerant to aspirin
  2. with aspirin after acute coronary stent insertion
  3. acute coronary syndrome
46
Q

What is an example of glycoprotein IIb/IIa antagonsit?

A

Tirofiban

47
Q

When are glycoprotein IIb/IIa antagonists used?

A

unstable angina and MI

Z Year3 Drugs (2 decks)

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